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FINAL APPROVAL
, '~sP.J£u5 DATE /. ?;·4/
·~L::ARANCE ---------
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 920()<) (619) 438-1161
PERMIT APPLICATION ~ ~
PLAN CHECK NO.
City of Carlsbad Building Department
l
~v~DF.POSIT,_ I 2075 Las Palaas Dr~, carlsbad., CA 92009 (619) 438~1161
I. WltMII IYP£ VAIIl>. BY, ___________ _
DATE
From List 1 (see back) give code of Pennit-Type: ____________ _
For Residential Projects Only: From List 2 (see back) give
Code of Structure-Type: ____________________ _
Net Loss/Gain of Dwelling Units
2. PRCllECT INFORMATION FOR OFFICE USE ONLY
Building or Suite No.
LEGAL DESCRIM ION Lot No. Subci1V1s1on Name/Number Unit No. Phase No.
CHECK BEWW IF S0BMI 11 Eb:
□ 2 Energy c.a)cs □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEi, ~STING USE PROPQSED USE
DESCRIPTION OF WORK "r,el'/lf.. o.t"J: //e!4V'( 5;,;,,~,"11'/lly ljr ,-,lywa;>~ "1/1,<l'J' us r./,e "c/,1y,.,"1'( ,,
SQ. FT. J t:?00 # OF STORIES / _:I' Cf 8F BtriR'ai°hs=> # OF BATHROOMS
3. WN IACI PERSON (I[ dHierenf from apphcanf)
NAME (last name first) ADDRESS
Cl1Y STATE ZIP CODE DAY TELEPHONE
4. APPIJCANI liJ.eONIRACIUR DA@Nl FORCONIRACIOR DOWNER OAGENI FOR OWNER
NAME (last name first) />ft/tJ/e_. /('"11V<Jy ADDRESS /~{,'iJ ,(5 ,4.m, /7,,,tr,,_,f/
CI1Y FfjC. STATE (' rJ ZIP CODE 'J)v 2. tJi DAY TELEPHONE 'J<'(S--J '/f f
5. PkuPFJlJY OWNliK
NAME (last name first) ADDRESS
CI1Y STATE ZIP CODE DAY TELEPHONE
6. rnN I RACIUk C) ~A~ 7£:... A
NAME (last name first) v/J1,,,. f /U/0~ Cr/l(_e..,_ ADDRESS ,(2_(:,"j ,6 ,4/,f7t7 /?,t,,1(/("vr
CI1Y ~-STATE Cl'Y. ZIP CODE ";:JV J_ ?J/ DAY TELEPHONE 1,,/°9-(;>q'~ -2 83 $
UCENSE CLASS ( -3 "f CI1Y BUSINESS UC. # L{) I.. 6 STATE UC. # 705V3
Cl1Y STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. wommru,.u WMPENSAIION
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Workers' Compensauon Declaration: I hereby afhrm that I have a cert1hcate of consent to selt-msure issued by ilie Director of lndusrnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
Owner-Builder Declaration: I hereby afhnn that I am exempt from the Confracfo?s License Law for the lollowmg reason:
I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds
or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended
or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden
of proving that he did not build or improve for the purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects
with contractor(s) licensed pursuant to the Contractor's License Law).
I am exempt under Section ________ Business and Professions Code for this reason:
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for such pennit to file a signed statement that he is licensed pursuant to the
provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pennit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
SIGNATIJRE DATE
COMPLEIE IHIS SECIION FOR NUN-RESIDEN l1AL BUILDING PERMIIS ONLY:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
□YES □NO Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management district?
□YES □NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES □NO
IF ANY OF TIIEANSWERS ARE YES, A FINALCER11FICATEOF oa:IJPANCY MAY NUT BE ]l?SllEI) AFTER JULY 1, 1989 UNlJ!SS 11IE APPUCANT
HAS MET OR IS MEETING 11IE REQUIREMENTS OF 11IE OFFICE OF EMERGENCY SERVICES AND 11IE AIR POLLUTION illNTROL DISTRICT.
9. WNSIRUCIION LHNDING AGENCY
I hereby afhrm that there IS a construction lending agency for the performance of the work for which thts pernut ts issued (Sec 3097 (I) C1Vti Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPllCAN I CFJUU'ICAIION
I certUY that I have read the apphcatmn and state that the above mformauon 1s correct. I agree to comply wtth all City ordmances and State laws
relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection
purposes. I AISO AGREE 1U SAVE INDEMNIFY AND KEEP HARMLESS 11IE Cl1Y OF CARISBAD AGAINST AIL UABIIITIES, JUDGMENTS, aJSTS
AND EXPENSES WHICH MAY IN ANY WAY ACDl.UE AGAINST SAID Cl1Y IN mNSEQUENCE OF 11IE GRANTING OF nns PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every permit issued by the Building Official under the provisions of chis Code shall expire by limitation and become null and void if the
building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by
such permit is suspended or abandone any ti after work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPUCANT'S SIGNATURE UT--' DATE: /(-)(.4&,
PINK: Finance
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CITY OF CARLSBAD
SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING
JOB ADDREss ,;)._t,, £('C::, Le{/f/NT-e_
TYPE OF BUILDING: RESIDENTIAL V COMMERCIAL __
ROOF SLOPE: RISE l{ inches in 12 inches
TYPE OF EXISTING ROOF COVERING f/e"111'( Sflr1ke... SHEATHING Sl:',fi -{ "'""'R~e,/6tt,,
NUMBER OF EXISTING ROOF COVERINGS (circle one)o) 2 3
NEW ROOF MATERIAL Cf ,?y /)1,f'x, CLASS ft WEIGHT PER SQUARE $: g
NUMBER OF SQUARES _if (e
TRADE NAME /,,{.'5_ iff,e__@/4y/411):J MANUFACTURER C{S, T,'/e_
ROOF SYSTEM APPROVAL UL No. 3S-J. S Other ___ _
IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF
THE PROPOSED ROOF YES v' NO __ _
If the answer is no, a roof plan must be provided with this application.
Fire rating of roof: Class A VClass B __
I understand the following inspections are required:
l. Tear Off/Pre-inspection prior to installing new roof covering.
2. Final Inspection
I agree to provide a ladder extending at least 2 rungs above the roof for inspection.
DATE
Contractor Contractor Name /J-mM.d. ~ ¼1,.J2 ~ Owner ---
*6 -Rolled Roofing, Tile, Shake, Shingle, Asphalt/Comp Fiberglass, Built up.
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB962271 FOR 01/03/97
DESCRIPTION: 36 SQUARES OF RE-ROOF W/LIGHT
TILE ICBO 3523
TYPE: MISC
STE:
INSPECTOR AREA DC
PLANCK# CB962271
OCC GRP
CONSTR. TYPE VN
LOT: JOB ADDRESS: 2646 LEVANTE ST
APPLICANT: OMNI ROOF CARE
CONTRACTOR:
PHONE: 619 945-2833
PHONE:
OWNER: PHONE:
REMARKS: MW/RANDY/945-2833
SPECIAL INSTRUCT: INSP CARD NOT ON SITE INSPECTOR.J:2~"-----------
TOTAL TIME:
--RELATED PERMITS--
CD
15
LVL DESCRIPTION
ST Roof/Reroof
DATE DESCRIPTION
120496 Roof/Reroof
PERMIT# TYPE
CB901170 RAD
STATUS
EXPIRED
ACT COMMENTS /l ,, 4i f·1114L-
***** INSPECTION HISTORY*****
ACT INSP
AP DC
COMMENTS
OK TO COVER